OBJECTIVE: To probe into the effects of different initial doses of sacubitril and valsartan on ventricular remodeling and myocardial enzymes in patients with chronic heart failure（ CHF）. METHODS: Totally 80 patients with CHF admitted into Emergency and Intensive Care Unit of Lujiang County Hospital of Traditional Chinese Medicine admitted into Mar. 2018 to Sept. 2019 were extracted to be divided into the observation group and the control group via the random number table

with 40 cases in each group. Patients in both groups were given Sacubitril valsartan tablets orally

with an initial dose of 50 mg for twice a day in the control group

and 100 mg for twice a day in the observation group. Both groups were treated for 12 weeks. The clinical efficacy and incidence of adverse drug reactions were compared between two groups. Ventricular remodeling indicators [interventricular septal thickness（ IVST）

left ventricular posterior wall thickness（ LVPWT） and left ventricular mass index（ LVMI） ]

myocardial enzyme spectrum[aspartate aminotransferase（ AST）

lactate dehydrogenase（ LDH）

creatine kinase（ CK） and creatine kinase isoenzyme（ CK-MB） ]

neuroendocrine hormones [norepinephrine（ NE）

aldosterone（ Ald） and angiotensin Ⅱ（ AngⅡ） ]levels

6 min walking distance（ 6 MWD） and Minnesota heart failure quality of life scale（ MLHFQ） score before and after treatment in both groups were compared. RESULTS: The total effective rates in the observation group and control group were respectively 97. 50%（ 39/40） and 95. 00%（ 38/40）

and the total incidences of adverse drug reactions in the observation group and control group were respectively 5. 00%（ 2/40） and 2. 50%（ 1/40）

with no statistically significant differences between two groups（ P > 0. 05）. After treatment

the levels of NE

ALD and AngⅡin the observation group were significantly lower than those in the control group

IVST

LVPWT were significantly lower than those in the control group

and IVMI were significantly higher than those in the control group

the differences were statistically significant（ P < 0. 05）. After treatment

there were no significant differences in levels of AST

LDH

CK and CK-MB between two groups（ P > 0. 05）

there was no significant difference in 6 MWD and MLHFQ scores between two groups（ P > 0. 05）. CONCLUSIONS: The clinical efficacy of different initial doses of sakubatril and valsartan in the treatment of CHF was comparable

and the effects on myocardial enzyme are not significantly different; however

high-dose sakubatril and valsartan is more likely to improve the myocardial remodeling and inhibit the release of neuroendocrine hormones.